Advice and warnings about expatriate health insurance (2024)

Policy rules

Geographic area:
Expatriate health insurance covers you in your destination country, and possibly in other countries if they are part of the same premium area or a less expensive one. You are also covered worldwide for certain emergency expenses related to an accident or unexpected illness. Each insurer defines its own rules for coverage outside the destination country, so check the terms and conditions before subscribing. International insurers generally offer worldwide coverage, or worldwide coverage excluding the USA. Some may offer more targeted coverage for regions such as Asia, excluding Singapore and Hong Kong. French insurers tend to be more area-specific, which often results in lower rates. However, if you want to be able to choose to be treated in a country other than your destination country, you must include it in your rate area. Inform your International Santé advisor so that they can take it into account when reviewing your file.

Coverage in your home country:
If you have chosen a plan with worldwide coverage, or worldwide coverage except USA, you will be covered in your country of origin. If you have chosen a country that offers another coverage system, your coverage will depend on the premium area in your country of origin and your destination country. In any case, read the terms and conditions of your chosen plan carefully, to avoid any concerns about coverage. International Santé advisors can provide you with all the information you need on the subject upon request.

Annual renewal:
Most global health insurance policies are renewed automatically. This means that the insurer can’t decide to cancel the policy of an insured person because they consider it to be too expensive. The insurer also can’t decide to increase an insured person’s individual rate. This guarantees that the insured person will be covered, even if they have already begun medical treatment. But be careful: Some contracts may have an end date linked to age (for example, turning 65), or to changes in your status such as retirement. If you are planning to remain abroad for a long time, or if you are approaching these types of milestones, feel free to consult your advisor.

These premium increases depend on the insurer, and are not necessarily applied on the same dates. They may occur on the anniversary of the subscription date, on December 31, or on the insured's birthday. This means that your first rate increase may occur only a few weeks after the effective date, or more than a year later.

Presentation of rates:
In our tables, we list the price per month to provide you with a uniform basis for comparison. The price per month is calculated by dividing the annual fee by 12. Each insurer offers its own installment plans (semi-annual, quarterly or monthly) for which they may charge a fee. The rates presented in our tables do not include these fees, but they are generally listed in the detailed tables found under Fees and charges.

How coverage works

Waiting periods:
Most expat health insurance policies have waiting periods, also known as delayed coverage. During these periods coverage is not granted, or is limited to emergencies. They can vary depending on the type of care. For example, there may be no waiting period for routine care, 3 months for hospitalization, 6 months for dental and vision care and 10 months for maternity care. Check the terms and conditions. They may sometimes be removed if an equivalent insurance has been cancelled recently. If this is the case, you’ll need to provide a certificate of cancellation along with a detailed table of benefits.

Maternity:
In many expatriate health insurance policies, maternity expenses are an add-on option and are subject to a 10-month waiting period. The expenses covered under this option also vary from one insurer to another. If you are planning a pregnancy, please inform your advisor so that they can find you a suitable plan.

All exclusions are specified in the Terms and Conditions of each policy, and an advisor can provide them to you upon request.

Direct payments and third party payments:
With the exception of the USA, there are no third-party payment systems equivalent to those offered in France by traditional health insurance companies. You pay for your health care expenses, and are reimbursed afterwards. However, for hospitalizations lasting more than 24 hours, the insurer pays the establishment directly.

Reimbursem*nt management procedures:
To handle reimbursem*nts, insurers may offer reimbursem*nt options by email, through an online customer service center or via smartphone apps. In some cases, insurers require you to mail them your original receipts (for invoices over €1000, for example) along with a reimbursem*nt request document that can be download from their website. If you live in an area where the postal service is unreliable, talk to an advisor so that this can be taken into account when considering insurance packages.

Repatriation assistance:
Repatriation assistance is offered as an add-on. Prices vary from one insurer to another. It covers medical transportation to a quality establishment, either in your host country, a neighboring country, or your country of origin. It is essential if you live or will be traveling in areas where the provision of healthcare is limited. It often includes many services designed to make your life easier in the event of a health problem: medical advice, addresses of health care centers, delivery of medication, etc.

Youmusttelltheinsurereverything

You have to answer truthfully and completely. However, each insurer asks different questions, and you should only answer the questions that are asked.

If you answer yes to a question, you will need to include information such as dates and details on how the situation is progressing in your answer. If you did receive any further monitoring or follow-up after a treatment, be sure to include that information.

For example: right ankle sprained in 2017, 10 days of anti-inflammatories and 10 sessions of physical therapy, no follow-up or aftercare.

In the questionnaires, we often find the terms "condition," "disease" and "symptom" and those insured may always know which term to choose. The easiest answer is to say, "It’s what you tell your physician when you explain the reason for your visit."

If you’re still sure, to avoid any problems, just answer yes to the question and explain your situation in detail. It is better to say too much than enough.

Theconsequencesofanincompletedeclarationcanbefar-reaching!

As soon as you submit a reimbursem*nt claim for the limb or condition in question, your insurer will probably receive the information created by the physician. If they consider a health declaration to be incomplete or inaccurate, they will not bother to ask you for an explanation. Depending on the seriousness of the case, the insurer may:

-Refuse to reimburse you
-Decide to exclude a specific pathology, body part or medical specialty
-Cancel your subscription outright while keeping any payments already made.

Saying that it isn't the same back pain or ENT problem as the one mentioned in the physician’s report will work either, because they can’t redo your whole medical history for every claim.

The concept of a false declaration applies here in a broader sense. If an insured person hasn't declared a medical condition and the insurer finds out, the insurer can decide that the insured made a false declaration, even if the insured hasn’t filed any claims for their undeclared condition. This is because, on the one hand, the insurer wasn't able to assess the insured's overall state of health at the time of application and, on the other hand, there is nothing to prevent the insured from filing claims for this undeclared condition later.